{"created":"2023-05-25T05:25:45.812195+00:00","id":4246,"links":{},"metadata":{"_buckets":{"deposit":"47a8c2f3-18a5-4c4e-901c-a96e923fe874"},"_deposit":{"created_by":17,"id":"4246","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"4246"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:00004246","sets":["29:31:124:125"]},"author_link":["13373","13363","13367","13394","13364","13391","13395","13384","13388","13380","13382","13371","13376","13385","13393","13392","13370","13379","13386","13378","13389","13377","13369","13372","13387","13383","13365","13375","13381","13366","13390","13374","13368"],"item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"A case of multiple gastric carcinoid tumors associated with Type A gastritis treated with laparoscopic distal gastrectomy"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"フククウキョウカ ユウモンソクイ セツジョジュツ オ シコウ シタ Aガタ イエン ニ トモナウ タハツセイ イカルチノイド ノ 1レイ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2018-02-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"76","bibliographicPageStart":"70","bibliographicVolumeNumber":"36","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"　Ａ型胃炎は、自己免疫機序による慢性萎縮性胃炎であり、抗壁細胞抗体によって壁細胞が破壊され、胃酸分泌能が低下し、ネガティブフィードバックによって高ガストリン血症を呈する。これにより胃底腺領域のEnterochromaffin-like cellが刺激され、Rindi分類の１型胃カルチノイドが発生するとされる。高ガストリン血症を伴うカルチノイドは多発例が多いことから、胃全摘術が行われることもあるが、近年では幽門洞切除術、内視鏡的粘膜切除術、経過観察など様々な治療方針がとられている。今回、我々は腹腔鏡下幽門側胃切除術を施行した１型胃カルチノイドを経験したので報告する。\n　症例は58歳女性。定期検診の上部消化管内視鏡検査で胃底部から胃体部にかけて多発する小ポリープを指摘された。胃穹窿部の１cm大の隆起性病変は増大傾向を認め、生検でNeuroendocrine tumor（NET） Grade １であった。抗胃壁抗体、抗内因子抗体が陽性で、血液生化学検査で血清ガストリン値が高値を示し、１型胃カルチノイドと診断した。胃穹窿部の粗大病変はEndoscopic submucosal dissection （ESD）にて治癒切除した。また、高ガストリン血症の是正による微小病変の縮小と増大防止目的に腹腔鏡下幽門側胃切除術を施行した。術後、ガストリン値は速やかに基準範囲内まで低下し、現在外来にて経過観察中である。１型胃カルチノイドに対しての腹腔鏡下幽門側胃切除術はよい適応と考えられ、今後の標準治療となり得る可能性があるが、２，３型に関しては転移頻度も高く、根治性も考慮した上で術式を検討していくことが今後も必要であると考えられた。","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"13385","nameIdentifierScheme":"WEKO"}],"names":[{"name":"スズキ, タケフミ"}]},{"nameIdentifiers":[{"nameIdentifier":"13386","nameIdentifierScheme":"WEKO"}],"names":[{"name":"サトウ, タミエ"}]},{"nameIdentifiers":[{"nameIdentifier":"13387","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ハチヤ, オサム"}]},{"nameIdentifiers":[{"nameIdentifier":"13388","nameIdentifierScheme":"WEKO"}],"names":[{"name":"タナカ, タカユキ"}]},{"nameIdentifiers":[{"nameIdentifier":"13389","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ナカノ, リョウ"}]},{"nameIdentifiers":[{"nameIdentifier":"13390","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ヤマガ, 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多発性胃カルチノイドの１例"],"weko_creator_id":"17","weko_shared_id":-1},"updated":"2023-05-25T06:28:31.960791+00:00"}